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Early detection of Melanoma: targeting high-risk individuals

Geller, A.C.

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doi: 10.1097/01.cmr.0000382780.51806.a9
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While mortality rates for many preventable cancers in the US and elsewhere have been decreasing for the past 20 years, mortality rates for melanoma have only recently stabilized. Population-wide strategies have been attempted including mass screening programs led by dermatologists, public and professional education campaigns led by advocacy organizations, and recent attempts to educate primary care physicians via novel educational materials. However, it is becoming increasingly clear that strategies to reach high-risk individuals most at risk of melanoma death are required. In nearly all countries, these at-risk individuals include persons of lower socioeconomic status and middle-aged and older men. In fact, white men ages 50+ comprise half of all melanoma deaths in the United States and thickest tumors are rising most sharply in persons of lower socioeconomic status. To this end, we will discuss combining well-known risk factors (eg, persons with many moles or atypical moles) with relevant demographic variables, selectively targeting persons with poor health insurance and suboptimal access to health care, and identifying persons who may be at greatest risk of nodular melanoma. Various screening strategies to reach high-risk patients will also be explored.

© 2010 Lippincott Williams & Wilkins, Inc.